My passion is to help others in the community, young, old, and everyone in between, find relevance and joy in learning, performing or listening to classical music.

Thursday, May 29, 2014

One musician's painful dilemma

© misu - Fotolia.com
I am writing this post because I want to be honest and because the subject I'm about to bring up is one that is often shoved under the carpet. Thankfully, I think more and more musicians are starting to open up about this topic which is leading to more information being made accessible. But even with this new sense of openness, I have to admit that I am still hesitant to write about what I've been dealing with the past few months.

All right, enough procrastinating.

Who knows when it all started. What I do know is that I have had two years of playing and performing piano with virtually no break at all.   I have also been accompanying too many people. I now know that I have, without a doubt, a limit. This is where it starts to get a little embarrassing. I should've known. I did know that I had a limit. But in all honesty I didn't know what to do.   I love playing, I love experiencing new music, I love working especially with young musicians, and I absolutely adore performing - it's all downright addictive to me. I also suffer from what I think a lot of other accompanists suffer from - the overachieving accompanist syndrome.  I live in a small town with two colleges music departments in my backyard.   It's like living in the musical equivalent of an all-you-can-eat buffet.   Yet there aren't many pianists in the area that can or will take on the work.   We collaborators also typically love to swoop in and save the day - it's in our genes.   And I don't want to leave out the economic side of all of this. I am a freelance pianist and an adjunct professor; my husband is in the beginning of starting up a private voice studio after his struggles in academia.   We have no full-time job between the two of us so each musician I say yes to accompany becomes part of the patchwork that is our income.  It is not easy to say no to work and it doesn't help when I happen to love what I do.

Back to my story...

This past December, as most people were headed to vacations and celebrations with family I was crazily putting together a solo piano recital since I had applied for a full time teaching position at the university where I've been working the past three years. I (wrongfully) assumed  that I would make it into the final round of interviews (that's good fodder for another post) and would need to give a recital so I had one month in which to throw something together.  At the same time I was preparing for that, I was also having to learn music for the upcoming onslaught of student recitals, which totaled around 25.  (I am now letting out a groan in complete awareness of how I dug my own grave.) Since it was also my daughter's vacation I was doing my typical thing with her which more often than not consisted of wrestling and tickling each other.  It was during one of those times that I felt something happen in my upper back and shoulder. I didn't think much of it at the time and I don't know that it would have become an issue had I not also been practicing so much, but it quickly became a problem and I started getting this horrible pit in the bottom of my stomach as I recognized that I would soon have a dilemma on my hands, pun completely intended.

Perhaps I should've stopped then.   But it's so hard. I had agreed to play for over 20 recitals and countless other juries and smaller performances.  It's not so easy to just call everyone up and say, "Sorry folks, can't play!"  (I actually did call up a colleague to ask for help but she couldn't come up with any alternatives either.)  This was not a simple matter - that's one of the things I want to get across in this blog post.   I think it can be easy for people looking into a situation like this to simply shake their heads and dismiss a musician such as myself saying something like, "She did it to herself.  She should have known to stop."   One side of me agrees with this but when it's your life, what you love, your sole means of providing income for your family and when there aren't many, if any, that can do what you do?  And then there's the fear that if you tell people what's going on you'll never be asked to play again.  I'm telling you right now it is downright terrifying.

I chose to plow on as carefully as I could. I immediately found a chiropractor in town that I trusted, I told her my situation and she understood.   We set up a plan to meet on a regular basis so that we could hopefully slow down and avoid any further damage. I also stopped practicing once I was done giving my solo recital.   For the entire semester any playing I did was for rehearsals and performing.  I did not see a doctor and I did not go to physical therapy -  I relied instead on my chiropractor, advil, and arnica while religiously doing exercises that I learned from the chiropractor, the Internet, and from physical therapists I have had in the past.

Why did I not go to the doctor or to see a physical therapist?   I have dealt with similar issues twice before,  once when I was still in school and another time as an adult. The first time I had to stop playing I returned home to consult with a world-renowned hand doctor and surgeon in San Francisco.   He referred me to physical therapy but after months of doing that and being miserable I still didn't feel any better. I returned to college, was approved to take non-musical classes while recovering and started seeing a chiropractor who also happened to be the organist at our church. In a month of seeing him my problems started to go away. By the next semester I was playing again pain-free.  Later when I developed issues I again saw a chiropractor who was able to help me within weeks.  That is why I didn't go to the doctors or to physical therapy this time.  I hadn't had success the first time so I didn't want to potentially waste the time or the money.  Keep in mind neither my husband or I have full-time jobs.  Difficult choices have to be made.

© lily - Fotolia.com
So here I am not feeling better yet, not playing very much, not sure what's going to happen next year, and afraid to even type.  (This is the maiden voyage of me using Dragon Dictation to write a blog post!)   Obviously this is not a great situation.   But to make lemonade out of lemons, I'm learning a lot about my body, I'm working on understanding how I can use my body better at the piano, and I am having to start thinking outside the box again, which in my mind is always a healthy activity.   I don't know exactly what's going to happen in the next year although I have already reduced my playing commitments significantly.   I'm trusting that in the end I will have a delicious, refreshing pitcher of lemonade by my side as I once again take to the piano to play my little heart out.

With all this said, I would ask that folks reading this be understanding and to not make comments that beat me up for how I've dealt with this most recent situation.  Trust me - I've had plenty of that already from myself!  Thank you.

For any musicians reading this who are experiencing pain while playing, know that you are not alone.  There are a lot of resources and wonderful helpful people out there right now - find them, ask me, or look at the comments below!  I am happy to help if I can and I'm hoping that people in the know will make some suggestions right here.

Here's to healthy playing!

26 comments:

  1. Erica--thank you for sharing such an open, heartfelt post with us. It really resonated. I also never like saying 'no,' for all the reasons you mentioned, and the few times I have needed to find a sub, couldn't find a single person who'd be willing to step in. I haven't yet been in your exact position, but that fear is always there--"what if...?" And who could fill in? Terrifying to think about, especially when it's your main source of income. It is for me too! I hope you feel better and let yourself rest some this summer. That's always a problem for me too... knowing when to stop!

    Just curious to see if you've gotten to read Thomas Mark's book, "What every pianist needs to know about the body?" This was the first book that got me really thinking about my entire body, and body mapping, etc. And I still consult it from time to time :)

    So maybe not the most helpful comment :) Just that I know a little about where you're coming from, and have yet to find a solution either! So I'll be really interested to see other comments. Hope you have the time you need to heal completely this summer!

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    1. You're comments are helpful, thank you! It is comforting to get support from a colleague. I truly believe the more we are honest with this issue the easier it will be for us all to solve the problems earlier on or better yet, to avoid them all together.

      I am currently reading Thomas Mark's book. I have to read it in very small doses so that I don't miss anything - it is incredibly dense stuff and I've never been very good at anatomy. I've met so many people on twitter that are involved with either Alexander Technique or body mapping so this type of approach was already on my radar. Like I said in my post, I'm sort of thankful to be in this situation because it's forced me to look into it. I think it will prove to be very useful in the future!

      Please be careful yourself. I think as collaborators we can often find ourselves in tricky situations. It can feel great to know that people appreciate our talents but that can also make it terribly difficult to say no.

      Listen to your body!

      Thanks again for your comment and encouragement. I really do appreciate it.

      All the best,
      Erica

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    2. I would definitely consider the Alexander Technique - check out http://alexandertechnique.com/musicians.htm

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  2. Have you thought about The Alexander Technique? There are many well know musicians who endorse it as a preventative measure, and it can also stop making any current injuries worse.

    I really hope you feel better soon. Everyone has their own opinion of chiropractors and I'm sure people will let you know theirs, but as long as you are getting better, that is the main thing.

    Here's a link with some history and info on Alexander.

    http://www.ati-net.com/articles/debiadam.php

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    1. Many thanks, Simon, for your suggestion. My husband, a singer, spent about a year working with an Alexander technician and he learned a lot from him so I picked up a little bit of it that way. It's definitely something for me to consider if I can find someone local that teaches it. I am reading a body mapping book called "What Every Pianist Needs to Know About the Body" by Thomas Mark and that's proving to be very useful. I think there's a DVD one can purchase to go along with it too...I need to look into that since I'm mostly a hands-on and visual learner.

      And yep, I've heard various opinions about chiropractors and I admit I avoided it for a long time before I agreed to try it. But now that I know what I like in a chiropractor and what I don't feel comfortable with, and because I've had success two times previously, I am pretty sold on the whole concept - it makes a lot of sense to me, much more so than the advice of most doctors which tends to be full of talk of drugs, surgery, or giving up the piano.

      Thanks again and all the best,
      Erica

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  3. Hey Erica, sorry to hear about your pain. As you know, I've had my own issues. The person who has helped me the most is a massage therapist in Roanoke Angelica Gillespie (540)239-0499. Not expensive. I'm happy to tell you all about my experience if you want.

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    1. Ben,
      I'd love to hear about what you've done to help with your situation. I know you did a lot of icing, which I'm also doing. And I'd like to hear about how the massage therapist helped. I'll be seeing you soon anyway so we'll be in touch!

      Thanks,
      Erica

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  4. Hi Erica,

    So sorry to hear your story. Just wanted to stop by and tell you how much I understand what you're going through.

    I'd been in this situation for years (well 7 to be precise), having weird feelings in my arms or simply hurting, losing sensation in ny fingers, everything related to possible cervical issues.

    I had countless medical exams, all inconclusive, x-rays, scanners, saw neurologists, people specialized in pianists' injuries, physiotherapists and so on. I was told countless times to quit playing but nobody clearly found a cause. Until last year, when my dentist found out my legs could be the cause of all this. And he was right. For less than $100, I can play pain free again and enjoy my instrument.

    The most important thing is to talk about it
    Yoga helped me tremendously coping with muscle relaxation and the gloomy mood during this long period.

    The positive side to the story: I learned how my body works and how to prevent injuries, and it made my playing more precise and more effective. I learned to practice without touching the piano (as I was afraid to hurt myself more, I tried to avoid playing as much as possible) and it forced me to change my habits and get a healthy lifestyle. Now I'd like to share this "knowledge" and experience with students too, because I really believe we don't talk enough about the body and injuries in universities.

    If I can be of any help, let me know, I'll be glad to share with you the little I know. I'm not a doctor but as I walked the walk, I might have ideas ;-)

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    1. Well you've got me curious! Your legs? I'd love to hear more about your experiences because yes, I agree, we need to keep talking about it.

      May I ask if you stopped playing completely? If so, how long did you take off from playing? I think that's one of the biggest questions I have. I don't know that I want to completely stop playing, plus I'm not sure I can really, but I also don't want to make matters worse. Now that we're in summer mode I'm trying to only do very short practice sessions with easier rep, really focusing on what I'm learning in this body mapping for pianists book by Thomas Mark. As I am sure it is with you, I simply can't imagine getting through this without playing at all.


      Thanks for chiming in and I'm eager to hear more...thanks for being willing to talk about it.

      -Erica

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  5. Erica,

    Your post is very reminiscent of my own experiences as a student, pursuing a career as a classical guitarist. I was playing between 6-8 hours a day, performing quite often - and loving every minute of it ... except for the pain. I'd had a few accidents in my life - including a bus accident in grade six which resulted in some minor whiplash and then a very bad back injury during my first summer at university, which I'm fairly certain is what led to the onset of the fibromyalgia that eventually led me to give up the guitar altogether about 19 years ago.

    The only reason that I've been able to start playing again, just a few months ago, is because I was able to purchase a new instrument that I don't have to hold in the same manner as a traditional classical guitar, which changes my posture, and I have some extremely good pain management now, which I didn't have back then ... however, even with what I take for the pain there are times when it is too much to take - though I have to say, if you ask me why I'm in pain and I say it's from playing ... I don't mind so much - music is such an amazing gift to experience that living with a little (more) pain is worth the trade off - and - on top of that - since I started playing again my compositional "juices" have been flowing like "Old Faithful" - so ... I'm extremely pleased with the return to the guitar, pain notwithstanding.

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    1. Peter,
      Thank you for chiming in here! Always good to get support from a friend. I am so glad you are playing again. 19 years is a long time to be away from something you love so much.

      I am quite curious about this new guitar of yours. Too bad you can't post photos on my blog...perhaps you could post one of how it works on my Facebook page? Just a thought and only if it's easy to do.

      Maybe I should get a redesigned piano with keys that are situated more like those ergonomic computer keyboards are? That would be interesting!

      And I completely get the feeling of wanting to play even if some pain is involved. It is so hard not to play. I'm doing a lot of mental practice - you know me, I'm a huge advocate of that type of practice and of audiating. But there's nothing like the feel of the sound coming out of the piano right in front of me. Sigh...here's hoping I'll be able to play more soon. Until then you can be sure that I'll be sneaking in some careful practice/playing sessions just to fill that hole in my heart!

      All the best to you,
      Erica

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  6. Well, legs of different length and feet problems put my whole body into an unbalanced state over the years, inducing a scoliosis, shoulders at a slightly different level, and of course cervical problems. The use of custom insoles made by a professionnal + a postural reeducation were very effective in my case. Of course, I keep doing a lot of yoga, it helps balancing your body and stretching muscles. Unfortunately, a manipulation of my cervical vertebras by the chiro left me with a tinnitus in the left ear. No luck.

    I never stopped playing completely, but it had a price: I popped a lot of antiinflammatory drugs and pain killers. When I say a lot, I mean A LOT. But when the problems started to be quite permanent, I reduced my practice to almost nothing. That was a bad idea: my playing technically suffered from it and it took me quite a while to come back to feel comfortable again.

    You have to find your own strategies. Mine was two cut practicing in 25 minutes periods with some stretching in between. Never more than two hours in a row. And never more than 4h a day. I began also focusing in my body a lot more than before which helped me technically speaking. Not accepting everything and doing only what I really wanted. Not putting me in situations where old muscular habits would surface again (at least for a while, until the healthy habits are completely natural and interiorized). And understanding that taking care of my body is part of my job.

    Believe me, at the beginning of all this I thought it was the worst thing that could happen. Now, I'm happy I got through this, I've learned so much along the way and I'm just thankful I can play again without any pain at all.

    P-A

    P.S: Mark's book is very helpful!

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    1. Wow, that is all so interesting! And I'm so glad you figured it all out for yourself. Like you said, I think we do have to find our own strategies and what I'm learning is that I have to pursue paths that make sense to me and that I feel good about. I quickly realized that going the purely medical route didn't align with what I believe in - I feel like that is just a band-aid approach. I need to understand what went wrong and what I've been doing at the piano that hasn't been optimal so that I can be more aware and make the necessary changes. I love what you said - "understanding that taking care of my body is part of my job." YES! That is so true and that's what I'm working on. I used to resist exercising and stretching but now I'm including it into my daily schedule so that I can be healthier and heal properly.

      I also think it's interesting that you feel like you shouldn't have taken so much time off playing when you were dealing with these issues. I think it's such a normal reaction to just completely stop playing but I don't know that it's such a good thing, at least not for me, in a spiritual, mental, and physical way. I'm allowing myself to practice for 10-15 minutes at a time but being sure that I'm very aware of my body and applying what I'm learning from Mark's book. So far it's working and not doing any harm, at least that's what I'm hoping. And that little bit of work and playing is what keeps me alive, as I'm sure you can relate to.

      Many thanks again!

      Erica

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    2. Sorry for the typos... Autocorrect sometimes works in a mysterious way :D

      You're a clever girl, you'll figure all that out quickly! I saw too many people getting "injured" who stopped playing "until it's fixed" and actually never played again or never fixed their problem.

      I think medical aid is useful to rule out certain specific issues like any spine/vertebra/skeleton problem, carpal tunnel syndrome... But most of the time a postural approach is the way to go. If you see doctors/physiotherapists/chiropractors, go to sports doctors, they'll understand better. For example, my leg/feet problems are not considered by normal doctors as something relevant: yep, the average guy coming into their office would not be severely impacted from this in his daily life as he doesn't walk a lot (cars) and doesn't use is muscular apparatus as much as we do (sitting at a desk clicking). I live in a city center, walk all the time + play the piano a lot. That's a completely different world from a muscular/postural point of view.

      Feel free to keep me updated by email, or just say hello and talk a little. I know that's a hard situation psychologically speaking and you need to talk about it. Consider this as a way learn about your body. Reading all your comments, I'm sure you're on a good way to solving this. Keep up the good work!

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  7. Great post! As a pianist and piano technician, I get a lot of repetitive stress. One technique that is widespread within piano technician circles is trigger point massage. It can be done by a massage therapist as well as by oneself. I have found it tremendously helpful in dealing with pain from playing in rehearsals for hours and hours. I find that it helps both with relieving pain and with helping me to heal faster. I have been using techniques from "The Trigger Point Therapy Workbook" by Clair Davies.

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    1. Peter,
      I had heard about trigger point therapy but hadn't looked into it yet. I will now!

      Many thanks,
      Erica

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  8. Erica- thank you for this honest and wrenching account of what you are experiencing. I am sorry to hear of your dilemma, as I'm sure all your readers are.

    As you know, you are not alone. Music is literally manual labour, and all musicians are at risk of injury and physical damage. Schumann, Heifetz, Fleisher, Graffman... the list goes on. Musicians need to be aware of the problem at all times, and you are to be thanked for sharing your plight in so open and honest a way.

    I suspect everyone will have their own nostrum and fix for your situation. I'd like to share with you what worked for me. I suffer from tennis elbow and extensor muscle strain in the right arm. The one-two punch that got it under control after some scary months was massage therapy and Iyengar yoga.

    My massage therapist has treated dancers and athletes, so he is no softie. He gets deep into the tissue. He is also experienced, so he was able to identify the lower part of my right scapula and upper part of my right pectoral muscles as the source of the tennis elbow. Now when I experience the condition, I know to deeply massage my shoulder blade and my pec, and it works 100% of the time.

    Iyengar yoga, which I've been doing for 8 years now, has put me on a path of mastering (or at least greatly heightening my awareness of) the body. It helps create awareness of the interconnectedness of everything. I understand that the elbow and arm are connected to the shoulder and chest, and I can do poses that strengthen or open them up, thereby releasing the elbow. It's a real discipline, not unlike classical music (in fact it was Yehudi Menuhin who introduced Iyengar yoga to the West). This dovetails perfectly with the lessons I learn from my massage therapy about remote points determining pain in the body. Best of all, I can practice the yoga on my own, at any time and place. It's like having a 24/7 portable treatment centre.

    My solutions may not work for you. But I want to let you know that, at least in my case, I have been able to get the issue of physical pain under control. I hope you find the right path for you to the same result.

    All best,

    Ron

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    1. Ron,
      Many, many thanks for sharing your experiences. I too am dealing with mostly tennis elbow issues in addition to that spot in my upper back/neck that hasn't completely gone away. Several of you have mentioned massage therapy and Ben, who commented earlier, happens to have a recommendation for someone nearby so I'll be contacting her. I will be sure to mention what your therapist discovered in regards to the scalpula and pectoral muscles. I wouldn't be surprised if that's part of the issue with me as well since I have a tendency to bring in my shoulders and collapse my upper body a bit when I play.

      I'll also look into the yoga that you mentioned. My husband has been trying to get me to try some sort of yoga for a year now - perhaps it's time I give it a try. I am very excited that you feel like it's brought you a greater awareness of your body...it's so important for me to feel like I'm learning so that I can apply it all to playing and to my general physical approach to everyday living.

      So we'll see what happens. Thank you again for chiming in and for your encouragement. It means a lot to me!

      All the best,
      Erica

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  9. Erica- Sorry to hear about your physical pain and ailments. Being a musician has a lot in common with being an athlete or a laborer and I think that thought is just starting to get some mainstream attention. A few years ago I tore my left rotator cuff, only an 1/8" mind you, but painful and restricting nonetheless. I was told that surgery could mean no violin and no guitar for at least six months. So I opted for 2 months of no violin while enduring physical therapy. Fortunately it worked and I was able to eventually return to the hours of playing that I had been. Fast forward a couple of years and I tear my right knee, have surgery and promptly tear it again. Since I was still paying for the first surgery - and desperate - I turned to yoga. Now five years later, and no surgery I only occasionally am reminded that I have an ongoing knee injury. The strengthening and stretching I learned from physical therapy, yoga and on-going massage therapy (that my wife bartered dance instruction for), I'm able to continue normal musical related activities as well as train a few hours a week in kung fu. Learning to treat your own body takes some time.. but well worth the effort! Hang in there!

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    1. Thank you for your reply and for your story, Darin. With yet another recommendation for yoga I think I am starting to get the message here. I just downloaded a yoga app so I'm going to give it a try in addition to trying some massage therapy and to continue trying to educate myself about all this body stuff. It does feel like a full-time job right now - hopefully the payment will be many more years of music-making and teaching. I miss it already and it hasn't been that long.

      And you have permission to bug me on twitter to make sure I'm really trying the yoga thing...I've been known to procrastinate and avoid.

      Thanks again!
      Erica

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  10. I can only say the following: You are a soloist and cannot hide anything anywhere. String players in orchestras that play a lot also play with a little pain sometimes. Their advantage is that among their many colleagues, they can safely "pull back" and not exert themselves so much without being found out. Only when necessary though. Sometimes, for the sake of the moment, one will play with all the enthusiasm and vigor one can muster - pain or no pain. It really depends on the piece one is playing. Not all music deserves that kind of devotion. I am sorry to hear about your dilemma. I have found that if I leave a concert with hands warm from playing and venture out into the cold, I will feel pain the next day. I now use gloves to keep my hands as warm as possible and for the same reason use a scarf, even when the temperatures are mild. All the best to you and may you get completely well very soon.

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    1. Thank you for taking the time to comment and lend your encouragement. It is amazing, isn't it, how much we have to figure out what our body needs, what it is negatively affected by, and how we can avoid problems...but in our line of work it is so very necessary. Perhaps there are some people that don't need to but I'm definitely not one of them.

      All the best,
      Erica

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  11. Hi Erica. I sympathize with everything that's happened to you. It's all too familiar as I've struggled with issues similar to yours. I don't know if you've heard of The Golandsky Institute but Edna Golandsky heads it up and she uses the Taubman approach to rehabilitate injured pianists. It's amazing the transformation that can happen through this approach. http://www.golandskyinstitute.org/

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    1. Thank you, Sarah. I have been reading about the Golandsky Institute and the Taubman approach. I've also watched some videos of some of their masterclasses and approaches. Very interesting stuff! I am definitely learning a lot through this whole process from different angles. My hope is that in the end I'll be playing again better than ever and that I'll be able to pass on some good instruction and advice to others.

      Thanks for reading and for your suggestion!

      Erica

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  12. I tried to post a comment on your thoughts about Schubert's Winterreise, but since it promptly disappeared when I tried to preview it before posting, I decided that particular blog must be defunct. Therefore, here, although not pertaining to your current topic.

    I wanted to thank you for your thoughts about "Die Nebensonne" and "Der Leiermann", while I was enjoying Dietrich Fischer-Dieskau's 1965 recording with Jörg Demus.
    There is anovel I've been reading where Schubert's organ-grinder is an important protagonist. If that sounds unpromising, the book is, I think, the real thing, a more intellectual than romantic enterprise, namely Andrés Neuman's" El viajero del siglo" (2009) (Traveller of the Century). If you have read it, I would love to hear how you responded to it.

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    1. Thank you for putting in the extra effort to comment here in spite of your difficulties earlier! I haven't heard of that particular book so I'm putting it on my list. I haven't studied Spanish in many years but would enjoy reading something again. I will let you know how it goes!

      All the best,
      Erica

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